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Request for Exclusions
[CPR] Possession, Use, and Transfer of Select Agents and Toxins (42 CFR 73)
OMB: 0920-0576
IC ID: 217504
OMB.report
HHS/CDC
OMB 0920-0576
ICR 202312-0920-005
IC 217504
( )
Documents and Forms
Document Name
Document Type
Form 0920-0576
Request for Exclusions
Form
0920-0576 Request for Exclusions
Attachment 4 - Request for Exclusions Restricted.docx
Form
0920-0576 Request for Exclusions
Attachment 4 - Request for Exclusions Restricted.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Exclusions
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
0920-0576
Request for Exclusions
Attachment 4 - Request for Exclusions Restricted.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
09-20-0170 National Select Agent Registry/Select Agent Transfer and Entity Registration Information System
FR Citation:
76 FR 4483
Number of Respondents:
1
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1
0
0
0
0
1
Annual IC Time Burden (Hours)
1
0
0
0
0
1
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.